Organization
VSVL MEDICAL SERVICES PLLC
Active
Other names
Mannam Medical
Organization subpart
No
Provider details
NPI number
Authorized official
PRASHANTH MANNAM (MD)
(718) 792-6000
Entity
Organization
Contact information
Practice address
1170 CASTLE HILL AVE, BRONX, NY 10462-4810
(718) 792-6000
(718) 792-6001
Mailing address
1170 CASTLE HILL AVE, BRONX, NY 10462-4810
(718) 792-6000
(718) 792-6001
Taxonomy
Speciality
Code
Description
License number
State
302F00000X
Exclusive Provider Organization
Primary
233520
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
03231734
—
NY
05
—
03566341
—
NY
Enumeration date
11/01/2012
Last updated
09/27/2022
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